Receiving care in the home is perhaps the most
flexible of all options. Caregivers who come into
the home can provide services that range from
stand-by oversight for a few hours a week to
round-the-clock care. When you engage a home health
care agency, they will supply caregivers with the
appropriate skills during the time that you request.
Before you plan for services with a home care
agency, you should get an assessment of your loved
one's care needs. Sometimes the agency can arrange
this assessment, and it should be performed by a
registered nurse.

Generally, most agencies want visits to last for
at least 3-4 hours, and some have weekly minimums as
well. If you request a caregiver in the home
24-hours a day, the agency will usually split the
time into two 12-hour shifts. Unique state labor
laws also factor into staffing for full-time
caregiving. Some agencies will provide "live-in"
caregivers, but there are requirements as to where
and when they are allowed to sleep and how much free
time they have.

An alternative to working with a home health care
agency is to hire an independent caregiver directly.
Because they work for themselves, you pay them
directly.

Home health caregivers can range in skill level
from untrained companions, to homemakers, to skilled
nurses. Many have completed programs to be Certified
Nursing Assistants or Certified Home Health Aides,
meaning they are trained to handle health issues
such as mobility, nutrition, toileting, hygiene and
behavior. These certifications may not mean that
they are able to provide nursing care such as
medication administration, injections or wound
care.

Cost: The annual cost of home
care varies greatly with the number of hours per day
that are needed. With the national median rate at
$19/hour for a licensed home health aide, 40 hours
of care a week would cost $43,472 per year*. The
cost of independent care providers is generally
lower than those employed by an agency.

Assisted Living Facilities

There is no standard model for assisted living
residences. They vary in size, appearance and types
of services they provide. Assisted living facilities
are a popular choice because they tend to have a
variety of social programs and offer a community
setting where residents can live relatively active
lives. On a visit you might find an exercise room, a
pool, hair salons, and a community garden. Residents
can take part in group sessions and social
activities throughout the day and some type of
religious worship service during the week.